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So much talk of this these days and yes, it all sounds wonderful...but I seem to hear so much more talk about it in a conceptual sense, not so much nuts and bolts. So I thought I'd table it here to find out...and who better to chat it out than us, eh? So many of us walking the ADAP, Ryan White, Part D tightropes.

So what does this kind of healthcare mean to you - really? What do you envision being covered/not covered, and in what amounts? How do you see it all being able to work? Be paid for?

To me, removing the "employment = healthcare" from the healthcare formula is my personal goal.If you're one on those with less than a great job, you probably have less than any healthcare.The old formula in the U.S. was job = healthcare. Not anymore.Places like Wally world think they are immune to stepping in line.Sure, they offer healthcare, but as I understand its only after a year of employment.And thats for full time employees, something Wally world has few of.And what about pre existing conditions during that years wait, and after?

No Employer based healthcare was a good idea once upon a time, but no more.We need better. And also, we need to take profit out of treating the sick. Even a dog deserves better.How anyone can argue with profiting off the sick, and justify high rise gold and glass insurance companybuildings at the cost of the ill, is beyond me. If everyone paid what is held out of their pay checks, and what they pay in deductibles, intonon employer based group plans thru non profit health ins companies, everyone could be covered.Everyone could have the best healthcare in the world, with money to spare. That includes those that fall unemployed,low waged and the old folks. But, greed loves greed. Humana, Kaiser, Cigna and Wellmark love their high rise gold plated buildings, as well as giving their investors a nice cushy profit. A totally sick, perverted system.

It should mean that everybody should have the medical care they need, without your ability to pay being an issue.

In practice, there is a finite amount they can spend. State dental care is limited, most people pay for their glasses and you pay for your perscription in the UK. Although, HIV drugs are free from Clinics.

Although the British like nothing better than whinging about the system, almost no one, including politicans support publically any idea other than universal healthcare is a fundamental right.

Here's a breakdown of Obama's and Clinton's healthcare plans. No need to include McCain's because he doesn't have one. It does require a bit of reading, but appears to be an objective comparison. I'll leave the screeching about socialised medicine in America to others. The closest we're going to get to universal healthcare are the doctor clinics that are springing up at WalMart.

I'm working with the Private Health Insurance Must Go Coaliition. SINGLE PAYER would mean every person residing in the United States would have complete healthcare coverage from womb to tomb. Yes, that includes non-citizens as well.

It would mean being able to choose whom you to go for healthcare. If you need medications of any kind they will be available for you. Preventive healthcare would also be covered. So would dental, eyeglasses, mental health and more.

By removing private insurance companies from the equation billions of dollars lost every year to their profitmaking would be channelled back into healthcare. Healthcare is not and never ought to have been treated like a business. Healthcare is a human right and not just another corporate profit opportunity.

For instance, any doctor in private practice will tell you what outsized part of his and his staff's time is spent in dealing with insurance companies and in many instances struggling to get an ok for patient treatment the insurance company is bent on denying.

Now I know there will be those who will say Single Payer can't work, why should so and so get free healthcare, what about the insurance I pay for and like, Canada has long lines for treatment, blah blah blah. Will any system ever be perfect? No. But Single Payer will go a long way to fixing a seriously broken system in our country under which many thousands of people die every year because they are denied healthcare treatment when they need it. And many thousands suffer for insufficient healthcare as a daily fact of life.

This has been the first year (not like it's been in place for years on end) that I've had to pay a co-pay for my prescriptions on my Medicare Part D plan. And because of that, I've let go of some of my medications that I don't find extremely necessary. It would be nice to not have to ponder over health matters. I do get Indiana Medicaid, but every month there is a $130 "spend-down" which has to be met before they will cover anything medically, other than paying the deductible for Medicare. So, if I want Medicaid to cover anything, I have to shell $130 out of my own pocket for medical expenses and provide the receipts to my caseworker. Ridiculous.

Logged

I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

I'm still reading up on posts (and especially the links provided), but I would like to take a moment to gush over all of you for your supreme awesomeness. In less than a dozen posts, this thread is already giving me so much back in terms of insight and personal education. I greatly appreciate it!

I'm working with the Private Health Insurance Must Go Coaliition. SINGLE PAYER would mean every person residing in the United States would have complete healthcare coverage from womb to tomb. Yes, that includes non-citizens as well.

It would mean being able to choose whom you to go for healthcare. If you need medications of any kind they will be available for you. Preventive healthcare would also be covered. So would dental, eyeglasses, mental health and more.

By removing private insurance companies from the equation billions of dollars lost every year to their profitmaking would be channelled back into healthcare. Healthcare is not and never ought to have been treated like a business. Healthcare is a human right and not just another corporate profit opportunity.

For instance, any doctor in private practice will tell you what outsized part of his and his staff's time is spent in dealing with insurance companies and in many instances struggling to get an ok for patient treatment the insurance company is bent on denying.

Now I know there will be those who will say Single Payer can't work, why should so and so get free healthcare, what about the insurance I pay for and like, Canada has long lines for treatment, blah blah blah. Will any system ever be perfect? No. But Single Payer will go a long way to fixing a seriously broken system in our country under which many thousands of people die every year because they are denied healthcare treatment when they need it. And many thousands suffer for insufficient healthcare as a daily fact of life.

Andy,

If you have any links for further reading about this, please post. I will admit, though - it does have a wonderful, yet pie-in-the-sky sound to it. "Free everything for everybody forever!!" Yeah. And an endless buffet line for all the starving children of the world. Imagine all the people sharing all the world & all that.

Sounds terrific. Sign me up. But tell me exactly how such a grand vision really can come into being. As much as I love the sound of it, it also seems a bit broad and over reaching for what might be possible.

I will whole heartedly agree, however, with the ideology of healthcare as a right vs. as a business. To me, it's a fundamental mark of a civilized people, no? I also agree about how much time and money is outsourced into dealing with insurance haggling. And for the life of me, I don't get how people can harp about the tax cost of such a system & not recognize how much money they are tossing out to insurance companies.

These are a few of my least favorite things about American healthcare:

- Americans can't agree that everyone deserves healthcare, that it is a basic right like police protection, fire protection or education.

- We are one of the wealthiest nations in the world but we "can't afford" healthcare for all our citizens.

- Many Americans are completely opposed to paying for another person's healthcare, even though they are already doing it inefficiently through hospital charges, insurance premiums, etc.

- Many Americans feel a free market strategy is the best way to handle healthcare. A free market strategy is great for making profit, not for taking care of who cannot participate.

- Political lobbyist are spending millions of dollar to prevent improvements to American healthcare to protect the profits of pharmaceutical companies, insurance companies, doctor's and administrator's salaries, etc.

I could go on but the bottom line is too many people think profit is more important than people.

I believe that of all the currently proposed "solutions" only one has a real chance of even partial success.....the single payer system....one of the "fundamental" issues of payment is that some people cannot "afford" health insurance....so that leaves this huge question of what does that mean? that they spend what money they have on other things? that they have no income? that they have "limited income"? that they have so many children that they spend all the money on food/clothing?...that they have too big a mortgage? and so on etc, etc.....there are unending questions concerning who pays what, when.....As currently proposed, a single payer ...presumably a govt agency would pay all medical expenses to the providers......how much each recipient of the care is asked to pay as a " deductable / co-payment / or premium would probably be a long drawn out political issue but like eating an elephant you eat one piece at a time and don't start at the back end...

Medicare currently has most of such a system in practice....the govt pays the provider and the recipient pays some co-payment based on a %age of the billed/accepted cost.... there are provisions for people who just cannot pay.( Medicaid) and even some relief for medications ( I know about the "hole") once the "administrative" cost of running so many "collection" agencies is dealt with then the bigger issue of "profit/ ownership" can be addressed...the govt has a lot of experience with building/staffing/ maintaining Hospitals..institutions ..clinics and many other forms of facilities with a wide variation of results.....having a govt agency "take over" the existing Private facilities would be a monumental task if not an impossible one so that is an open discussion..... the issue of the providers themselves is still an open discussion.....some would not choose to participate ( as is the case now) would they be "required" to participate as they are in some places?summary... a single payer system with a single agency as the billing/collection/paying responsibility is possible and would be a major step to undoing the big hodgepodge of care/payment policies that is now in place...and should be able to allow anyone who needs care to get it...This will take enormous Political will.... has any candidate shown this level of commitment?

Policy wonks may find the presentations at the recent conference of the National Academy of Social Insurance "Getting to Universal Health Insurance Coverage" interesting reading / listening. NASI has representatives of all the major points of view from academia, the fed agencies, the private sector and the think tanks (Gruber, cited in the fact check link above, was one of the conference organizers)

Assurbanipal -- who believes that because of a little problem called Congress neither Obama's nor Hillary's health care plans are likely to be enacted as anything like what they set forth on the campaign trail anyway. But the more they talk about it the more they can claim a mandate for some change to happen!

I'm working with the Private Health Insurance Must Go Coaliition. SINGLE PAYER would mean every person residing in the United States would have complete healthcare coverage from womb to tomb. Yes, that includes non-citizens as well.

It would mean being able to choose whom you to go for healthcare. If you need medications of any kind they will be available for you. Preventive healthcare would also be covered. So would dental, eyeglasses, mental health and more.

By removing private insurance companies from the equation billions of dollars lost every year to their profitmaking would be channelled back into healthcare. Healthcare is not and never ought to have been treated like a business. Healthcare is a human right and not just another corporate profit opportunity.

For instance, any doctor in private practice will tell you what outsized part of his and his staff's time is spent in dealing with insurance companies and in many instances struggling to get an ok for patient treatment the insurance company is bent on denying.

Now I know there will be those who will say Single Payer can't work, why should so and so get free healthcare, what about the insurance I pay for and like, Canada has long lines for treatment, blah blah blah. Will any system ever be perfect? No. But Single Payer will go a long way to fixing a seriously broken system in our country under which many thousands of people die every year because they are denied healthcare treatment when they need it. And many thousands suffer for insufficient healthcare as a daily fact of life.

I would love to see a Single Payer System -- I agree with most of what you say here. One area that is definitely NOT wrong, but incomplete, is this seems to be a way to end the profitmaking of Insurance Companies, but I doubt that they are the biggest profit makers. In little ol' Richmond, VA, we find that the hospitals have some of the biggest profit margins around -- in fact the one with the biggest is a NOT-FOR PROFIT Hospital (they, of course, call it "excess revenue" vs. profit). Insurance companies definitely create tons of overhead that would go away with a Single Payer system -- but then we must remember and accept that many jobs would also go away -- and not just the "fat cat executives". I worked for a health insurance company in Boston for 10 yrs -- I didn't make a big salary and I DID provide healthcare. So, while, again, I would like to see us head there, we have to remember that it can't be an event -- it will need to be a process.So -- here's hoping that a politician will have the political will -- of course, he or she would likely get voted out because, in general, Americans want the best health care, but they want someone else to pay for it.

Finally -- I'd have to further explore what "non-citizens too" means before I could endorse something like that.

As always -- this is a good debate -- so long as we all remain civil.

Oh yeah -- to answer the original question of the thread -- I think it means that everyone gets the health care that they need without being financially ruined in the process (which does not necessarily imply that it comes without some cost).

To me, removing the "employment = healthcare" from the healthcare formula is my personal goal.If you're one on those with less than a great job, you probably have less than any healthcare.The old formula in the U.S. was job = healthcare.

*snip*

Employer based healthcare was a good idea once upon a time, but no more.We need better. And also, we need to take profit out of treating the sick. Even a dog deserves better.How anyone can argue with profiting off the sick,

*snip*

Amen brother!! Y'know, since you mentioned Humana et.al I wanna bring up my experience with Oxford (now part of United Healthcare I think) ... I mean these guys were my supposed health insurer so at the risk of sounding too literal with my next statement, why didn't they insure my health? Was it because I was already healthy? i.e. HIV negative and good health (no thanks to Oxford)... I mean danm, even in good health they're supposed to theoretically ensure my health e.g. send me some f*cking coupons for vitamins or some educational brochures about biology hello, something! I kid you not when I say all Oxford did was collect my premiums. Probably with their feet up on their desks. File under P for profit. Y'know I've said it before and I'll say it again: Oxford must've loved me, the "ideal plan participant." And who's to say if they would've been my support (ally) or hassle (enemy) if something happened to me. I'm guessing the latter.

Well after the debates, don't be looking for Universal Health Care as other countries have. Because the definition of Universal Health Care in the US is defined as Affordable Health Care. With Obama's health care proposal it states you don't take out insurance and "PAY" for it, you will be cited. So now the insurance you couldn't afford to begin with, now will get you another finical burden a sitation. Now is that the Universal Heath Care that you were all talking about?

I agree with Andy... and I also want to say... the escallating cost of healthcare would come to a complete halt...unfortunately well will have everyone who lobbies for the healthcare insurance companies in Washington DC fighting tooth and nail against this... I have never understood why most health insurance companies do not provide preventive measures but, will pay out the nose when someone becomes ill... stating its not cost effective? Until Congress pushes for REFORM and I mean real REFORM of our nations Healthcare more and more people will fall through the CRACKS and our Healthcare will continue to climb at escallating hights... I think everyone in this Nation should have the same healthcare as to which our representatives have given themselves in Washington DC... Remeber their employees of the people of the United States and the people of this Nation are their Employers... I think our reps in Washington DC need to be Reminded of this!

I mean danm, even in good health they're supposed to theoretically ensure my health e.g. send me some f*cking coupons for vitamins or some educational brochures about biology hello, something! I kid you not when I say all Oxford did was collect my premiums. Probably with their feet up on their desks. File under P for profit. Y'know I've said it before and I'll say it again: Oxford must've loved me, the "ideal plan participant."

While we absolutely need to change how we finance healthcare in the US, I think there seems to be some unrealistic expectations of the current paradigm. For example -- Why do we expect a health insurer to do things that we wouldn't expect any other type of insurer to do? I don't get money or coupons from my auto insurer to pay for oil changes -- I don't get money or coupons from my home insurer to pay for air filter in my heating system. Remember they are not ENsuring your health, they are INsuring it. Granted, they could save themselves $$ in the long run if they did more to help folks meet preventative care, but you aren't necessarily going to be with the same company if/when you have a major health issue, so they may not be saving themselves anything.Now, before anyone starts yelling at me -- I'm not defending our current system or ever the health insurance companies. We currently have a system that sucks -- but it is what we have, so we shouldn't expect a company that is beholden (legally) to stockholders to do things that go against their primary goal. Our anger and disgust may be justified against some individuals in the industry, but it really needs to be sent to those who have the power to change it -- our elected officials. We can't and shouldn't expect all that we want/need from the current system -- that is why we need it changed. Expecting coupons for vitamins or anything like that is simply setting yourself up for major disappointment. My take on insurance (all types of insurance) is that you have to have it, but hope to never need it.Now -- let's redirect anger and disgust toward those that CAN help us all get the healthcare system we should have.